Lucky Bob?

It was recently suggested to me that Peter Piot, discoverer of the Ebola virus, has proclaimed that journalists save more lives than scientists. I haven’t heard this myself but I am aware that he has said numerous times that journalists save more lives than doctors. He initially made that statement in the context of HIV – years after its discovery. More recently he applied the same mantra to Ebola.

You can see where he is coming from. In public health terms, information is key. In the case of 2014 Ebola epidemic there was a major journalistic effort called ‘Info Saves Lives‘ that probably contributed to reducing the number of people infected through the collective action of journalists. Another specific example comes from the efforts of a journalist called Ellen Gabler who raised awareness of the need for newborn screening.  In both these cases the journalists were taking on a role akin to investigative public health officials -reporting accurately on an issue with which they had become familiar after its emergence to raise public awareness.

But journalism is not in itself a discipline devoted to life-saving activities and journalists are not accountable in these terms.  It is therefore within their gift to take on a health-related issue and we cannot oblige or rely on journalism to save lives for this reason.

 

A false dichotomy

I think that comparing doctors and journalists is essentially a false dichotomy. With some cursory thoughts we can already see how different domains can contribute to providing part of the solution, but no one discipline can take all the credit:

Scientists do not serve on the front line of public health. The scientific interest often precedes the journalistic interest but typically rises in response to doctors reporting about individual or clusters of cases. Scientists who become interested in an emerging issue  can become pivotal actors in researching solutions, but they have to write a proposal, compete for funding, undertake the work and eventually publish.  This can take several years. Sometimes the scientists and doctors work together.

Journalists work on front line of public information, on the basis of following ‘newsworthy’ stories. A story may become newsworthy at any time.  I have often thought that one reason why the 2007 crash didn’t actually cause a global meltdown is because the action of journalists hastened intervention. But on the other hand, the lack of, or cyclic, interest by journalists in reporting on a particular issue can feed wider social and political attitudes  which can the impinge on intervention  (e.g.  HIV in the 1990s).

For the journalists to act in a public health role then they need to have read at least some of scientific literature and/or talked to doctors. Perhaps due to a lack of scientific training among journalists, science journalism as a sub-discipline does not enjoy the best reputation as highlighted (by a science journalist) in the deliberately false ‘chocolate diet‘ project.

Doctors work on the front line of patient care, are limited in their scope of scientific work but provide the basis for alerting scientists to the need for research and  doctors are likely to have read some scientific literature to raise awareness of the issue so that they become competent in terms of care they can offer.

Public Health officials are on the front line of public information, they read the scientific literature and the doctors’ reports and synthesise ‘official’ guidance for the public good. Public health organisations such as Public Health England employ ‘communications officers’ who may find themselves talking to journalists if the journalist is convinced the story is newsworthy.

Scientists vs journalists

Scientists are not so needy of journalists before they are ready to announce their results. They are worried more perhaps about jumping the gun with preliminary results, and worried about losing control. Journalists do not generally have the capacity to learn the minutiae of the science at the point when the scientist releases the results.  This tension between science reporting and journalistic reporting is well known. It can be thought of as (often poorly) negotiating a trade-off between accuracy and readability,  summarised in this chart.

Lucky Bob

Let’s suppose a person called Bob is working abroad when an Ebola epidemic strikes. Bob hears about the problem from a journalist on the radio, and reads official public health guidance on how to avoid infection. He suddenly falls ill and quickly visits the doctor who diagnoses him with Ebola and gives him a new medicine that was recently developed by scientists.

Bob knew nothing about Ebola or the medicine prior to this point. But who actually saved his life? Under this scenario no one discipline can stake that claim because the end result is a chain of probabilities and decisions made by Bob and all the other actors in this drama. Was it the doctor who delivered the medicine, or the journalists for alerting Bob to the dangers and warning him to act quickly? In some way Peter Piot himself saved Bob’s life. But what about the people who trained Peter Piot? What about the scientists who developed the medicine?

I think the best we can do in this situation is acknowledge that Bob’s life was saved by the collective effort of a wide array of actors who coincidentally aligned their interests in a way that benefited Bob at that particular time. Bob was essentially lucky. Now let’s say that for every Bob there was a hundred people in approximately the same situation who didn’t get Ebola. To what do we attribute their success? It is still a chain of probabilities and decisions which perhaps stops at the point where the survivors heard from the journalists about the dangers and took effective measures to protect themselves.

I think the dichotomy about doctors and journalists stems from the fact that observations on individuals are censored at some point when an organisation counts the survivors. Survival analysis is likely to show that responding to journalistic output in the period before censoring happens is associated with lack of infection, but for those who become infected, prompt treatment by doctors is the life-saving event. Whether or not the medicine was available is not considered in this comparison as it only available to those who are already infected.

We should all be in it together

Have a look at this graphic. It was produced to highlight just how many disciplines can contribute to resolving health issues associated with neglected tropical diseases such as Zika.  This amount of collaboration would be appropriate, with some tweaking, for many other infectious diseases with complex life cycles.

Zika and NTD disciplines

Here are some thoughts on how to move forward and resolve some of the tensions and remove false dichotomies.

In an equal-opportunities and egalitarian world of trans-disciplinary co-operation, the journalists and scientists and doctors and public health officials would sit side by side from the point at which a problem is identified. The doctors would tell the journalists and scientists about the cases, the journalists would report that the science is on its way and the scientists would get to work.  The journalists would learn from the doctors and the scientists during the project so that they could report accurately in a way that would appeal to the public. The public would receive messages through other channels such as theatre, music etc. The public would expect the result, which would be published by the scientists and disseminated by the journalists and public health officials. If the science were to ‘prove’ nothing, everyone would have still learn something. If the science were to ‘prove’ something, everyone would have learned something. What would happen next would depend on the nature of the problem.

Importantly,  no-one discipline would  take the credit for the ‘proof’, no one discipline would decides what would be newsworthy. Because the point where the story begins is the point where everyone starts learning and telling the story.

 

 

 

 

 

transdisciplinarianism

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tropicalepi View All →

I am an epidemiologist based at a UK Higher Education establishment (Durham University, if you are interested). My research interests are primarily within the domain of Neglected Tropical Diseases (NTDs). I believe that the only way we can effectively tackle complex problems affecting populations living in tropics and sub-tropics is through trans-disciplinary collaboration. My working definition of transdisciplinary is undertaking research alongside so-called 'stakeholders' - groups and individuals who do not call themselves 'researchers' but whose experiences and knowledge can be used to great effect when combined with the experiences and knowledge of the research community. You can read my online CV at the link below.

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